Combining strength training and botulinum neurotoxin intervention in children with cerebral palsy: the impact on muscle morphology and strength

15 children with cerebral palsy were randomized to a 10-week strength training program either pre- or post- a series of Botulinum Toxin Type-A (BoNT-A) injections to evaluate the effects of strength training with BoNT-A treatment on muscle strength. Eight of these children also underwent a 6-month control period, receiving BoNT-A injections only. Results at 6 months indicated that strength training with BoNT-A injections provided no difference in knee flexor strength, knee extensor strength, spasticity, or motor control. Between the pre- and post- groups, there was no difference in these outcomes in the hamstrings, plantarflexor and dorsiflexor muscles.